Haemostatic fleece (TachoComb) to prevent intrapleural adhesions after thoracotomy: a rat model.

Abstract

BACKGROUND: Postoperative adhesion is a complication common to all surgical subspecialties. TachoComb is a collagen fleece with properties well suited to the prevention of adhesion. This preclinical study was performed to evaluate the efficacy and mechanism of action of TachoComb in the prevention of adhesion following pleural injury during thoracic surgery. METHODS: Rats (n = 72) were randomised to receive saline or TachoComb following pleural injury. The macroscopic severity of adhesion formation and histological changes were assessed following euthanasia at time points up to 28 weeks post-operation. Levels of the biochemical markers t-PA, PAI-1 and bFGF were measured in intrapleural lavage fluid. RESULTS: The severity of adhesion was lower in TachoComb-treated animals compared with control animals at all time points (mean adhesion score: 1.4 vs. 4 at week 28 post-operation; P < 0.01). Regeneration of the mesothelial cell stratum occurred faster in TachoComb-treated animals, and a significantly lower PAI-1 activity was observed (14.32 vs. 23.28 U/ml; P < 0.01). CONCLUSIONS: TachoComb is effective in the prevention of adhesion following thoracic surgery, both by acting as a physical barrier and by inhibiting PAI-1 activity.